Quinlan Case

Karen Ann Quinlan became the first legal case in what would later be known as the "right-to-die movement." Her case highlighted the widening chasm between medical technology and what is considered a "good death." For the first time, many Americans found themselves thinking about important decisions that need to be made at the end of life. Karen Ann Quinlan was born March 29, 1954, in Scranton, Pennsylvania, and was adopted by Joseph and Julia Quinlan and raised in Roxbury Township, N.J. She was by all reports leading a normal, healthy life.

On April 15, 1975, a few days after moving into a new house with two roommates at the age of 21, Quinlan attended a friend's birthday party at a local bar where she reportedly had a few drinks in addition to Valium. After feeling faint, she was taken home and put to bed; and after fifteen minutes she was found not breathing. An ambulance was called and mouth-to-mouth resuscitation was attempted. Quinlan was admitted to Newton Memorial Hospital in New Jersey, where she was given oxygen and put on a ventilator. In the emergency room, her pupils did not react, she did not respond to deep painful stimuli and was unable to breathe on her own, all indicators of extreme hypoxic brain injury. It was determined after several days that Karen Ann was in an irreversible coma, also known as a persistent vegetative state (PSV). She was transferred to St. Clare's Hospital for long-term care.

After receiving the news that Karen Ann's condition was irreversible, the family met to discuss the next step. They decided that Karen Ann would not want to be kept alive by machines and artificial methods. They reached the decision to take Karen off the ventilator and allow her to return to her natural state. The Quinlans received support from their priest and the Catholic Church, and with this support, they met with Karen's doctors and officials at St. Claire's hospital on July 31, 1975, to request the removal of the ventilator. The hospital representatives initially agreed, but then changed their minds, setting the stage for the legal battle that ensued.

Quinlan's physician argued that because she was not brain dead, both medical standards and ethics required him to continue treating her, with the respirator being part of that treatment. The government also intervened, arguing that the state's interest in protecting the sanctity of life must be protected and that removing the respirator was tantamount to criminal homicide.

The New Jersey Supreme Court rejected both arguments, deciding that Quinlan's right to privacy, protected by the Constitution, was violated when her physician and the hospital refused to remove the respirator. Although the court recognized that the state had an interest in preserving life, it found that interest weakened and the individual's right to privacy grew as the degree of bodily invasion increases and the prognosis dims. The court also rejected the idea that the medical profession was required to use all means at its disposal to keep patients alive. Rather, the "focal point of the decision [to terminate treatment] was whether the patient would return to a 'cognitive and sapient life' or remain in a 'biological vegetative existence.'"

As to who could make the decision to remove life supports because Quinlan was unable to, the court held that it could be her father. Practically, according to the court, Quinlan's right to privacy would be rendered meaningless unless her father could exercise it on her behalf. Central to the court's decision was its belief that Quinlan's father was of "high character" and very "sincere, moral, ethical, and religious." The court rejected the argument that her father's grief and anguish would distort his decision-making process, making him unable to make life-and-death decisions concerning his daughter. Karen Ann was removed from the respirator but continued to receive artificial nutrition and hydration. She lived another nine years in a nursing home until her eventual death on June 11, 1985 from pneumonia.

The Quinlan's legal case set precedent and established a patient's right to refuse medical care and control his or her own medical treatment. Because of Karen Ann Quinlan, changes were made in the way health care decisions are made, including the creation of ethics committees in hospitals, nursing homes, and hospices, the creation of advance directives, and the invention of Health Care Proxies. Karen became the symbol of abuse of technology in this technological age. She gave both fields -- law and medicine -- a case they could not avoid.